{
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"FirstLineMailingAddress": "4424 WALNUT RD",
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"FirstLinePracticeLocationAddress": "2331 YORK RD STE 102",
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"PracticeLocationAddressCityName": "LUTHERVILLE TIMONIUM",
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"PracticeLocationAddressTelephoneNumber": "410-816-9660",
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"EnumerationDate": "06/27/2022",
"LastUpdateDate": "06/27/2022",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
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"Taxonomies": {
"Taxonomy": {
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"LicenseNumber": "01606",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}